Objective To evaluate the efficacy of oxycodone for painless gastroscopy in pediatric patients when combined with propofol.Methods Sixty pediatric patients of either sex,aged 2-7 yr,weighing 10-28 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective painless gastroscopy,were divided into 2 groups (n=30 each) using a random number table:oxycodone group (O group) and sufentanil group (F group).The pediatric patients held by their parents entered the gastroscopy room,and propofol 1.5-2.0 mg/kg and penehyclidine hydrochloride 0.3 mg were intravenously injected.Oxycodone 0.1 mg/kg and sufentanil 0.1 μg/kg were intravenously injected in O and F groups,respectively.When body movement occurred during operation,additional propofol 1.0 mg/kg was intravenously injected.The occurrence of adverse reactions such as intraoperative body movement,laryngospasm and respiratory depression was recorded.The occurrence of postoperative vomiting and pain (FLACC pain scale scores ＞3) was also recorded.Results The incidence of intraoperative body movement,laryngospasm and respiratory depression and postoperative pain was significantly lower in O group than in F group (P＜0.05).Conclusion When combined with propofol,oxycodone produces better efficacy than sufentanil for painless gastroscopy in pediatric patients.

Objective To evaluated the application value of mean corpuscular volume(MCV) and red blood cell volume distribu-tion width(RDW) in predicting early treatment responses of non-severe aplastic anemia(NSAA) .Methods 101 cases of patients who were newly diagnosed with non-severe aplastic anemia and were treated with Cyclosporine (CsA)combined androgen therapy . Treatment before baseline MCV ,RDW value were measured ,treatment for 3 months ,6 months test routine blood ,reticulocyte indi-cators and treatment results were statistically analyzed and receiver operating characteristic (ROC) curve was used to estimate the sensitivity and specificity of MCV ,RDW in predicting early treatment results .Results The level of MCV and RDW in non-severe aplastic anemia were significantly higher than normal reference .the responded patients had significantly higher pretreatment base-line MCV value than those non-responded .especially at 6 month ,baseline MCV were 105 .10 fl and 98 .30 fl respectively (P=0 .025) .the responded patients had significantly lower pretreatment baseline RDW value than those non-responded .especially at 3 month .baseline RDW were 14 .60% and 16 .60% respectively(P=0 .001) .The cutoff level of MCV (100 fL) and RDW (15 .55% ) for the predicting 3 and 6 month treatment responses were established based on the ROC curve ,with degree of accurancy of MCV was 62 .4% ,61 .4% and RDW 70 .3% ,63 .4% respectively .compared the treatment efficacy acuity MCV ≥100 fL/RDW <15 .55%group was significantly better than MCV < 100 fL/RDW≥15 .55% group .Multivariate analysis showed that pretreatment RDW and absolute reticulocyte value was the early prognostic factor of NSAA treatment effect .84 patients with ARC ≥ 20 × 109/L , through RDW cutoff Layered compare treatment response :RDW<15 .55% group was significantly better than the RDW≥15 .55%group(P=0 .000) .Conclusion MCV can not serve as of a significant predictor of early treatment response in non-severe aplastic a-nemia .RDW can serve as of the bone marrow failure severity indicators and a significant predictor of early treatment response in non-severe aplastic anemia .The joint reticulocyte absolute value parameters ,which can more accurately predict treatment efficacy .

Objective To investigate the value of multi-slice computed tomography angiography (MSCTA)in the detection of intracranial micro-aneurysms(aneurysm≤3 mm in maximal diameter, IMA).Methods The clinical history and images of 826 patients with suspected intracranial aneurysms were retrospectively analyzed.All patients underwent MSCTA on 16-slice row CT before hospitalization(from 2 h to 4 d after symtom onset).All intracranial aneurysms were confirmed by digital subtraction angiography (DSA), three-dimensional rotational angiography (3DRA) or surgery.Two independent radiologists assessed all the images.The MSCTA findings were compared with the DSA/3DRA results.The sensitivity, specificity, and accuracy of MSCTA for diagnosis of IMA was calculated.The diagnostic consistency between DSA/3 DRA and MSCTA was determined by Kappa statistics.The prevalence of multiple aneurysms between the group of patients with IMA and the group of patients without IMA was evaluated by Chi-square test Results A total of 889 aneurysms in 788 of the 826 patients were detected.Among them, 706 patients had single aneurysm and 82 patients had multiple aneurysms.No aneurysms were detected in 38 patients.Among the 212 patients who underwent DSA/3 DRA, 271 aneurysms were found and 232 were IMA.MSCTAdetected 229 IMA.There was 1 false-positive finding and 4 false-negative findings by MSCTA.The sensitivity, specificity and accuracy of MSCTA for IMA was 98.3% (228/232), 97.4% (38/39), 98.2% (266/271).There was excellent agreement between two techniques (Kappa=0.927, P<0.05).The prevalence of multiple aneurysms was 21.2% (45/212) in the patient group with IMA and 6.4% (37/576) in the group without IMA.There was statistically significant difference between the two groups (X~2=36.421, P<0.01).Conclusions The detection value of IMA by MSCTA was high.The cutoff level of diameter of intracranial IMA should be adjusted from 4-5 mm to ≤3 mm.

Objective To summarize the experience of surgical treatment of ascending aortic aneurysms and aortic dissections. Methods From February 2001 to October 2005, 31 patients including 26 male, 5 female, aged 41.3 years old (range 14-72) received surgical management. Twenty cases were diagnosed as ascending aortic aneurysm and aortic root aneurysm, 8 as Standford A dissection, 3 as Stanford B dissection. Twenty-one patients underwent classic Bentall procedure in which VSD repair was carried out in 1 case, mitral valvoplasty in 2 and mitral valve replacement in 2; Four patients underwent modified Bentall procedure (coronary button technique); Three patients underwent Wheat procedure; The remaining 3 patients with Stanford B dissection underwent graft replacement of descending aorta. Results There was no death during hospital stay that lasted 13-46 d with an average of 16.4 d after operation. The mean clinical follow-up was (21?18.5) months (range 1-63 months). One patient died without describable cause two years later. One patient had ascending aorta-pulmonary artery fistula at color Doppler examination half a year later. One patient was detected rupture of distal anastomoses half a year after operation and underwent stent-graft, SG. Conclusion The surgical treatment of aortic aneurysms and aortic dissections could be carried out safely based on the accurate diagnosis, specific surgical strategy and fine technique.

Objective? To investigate the level of resilience and influencing factors among young stroke patients, so as to provide theoretical basis for carrying out nursing intervention. Methods? A total of 160 young stroke patients hospitalized in Neurology Department of the First People's Hospital of Xuzhou from January 2013 to December 2015 were selected by convenience sampling method. All the research subjects were investigated with the general questionnaire, the Connor-Davidson Resilience Scale (CD-RISC), Social Support Rat Scale (SSRS), Self-Perceived Burden Scale (SPBS) and Mishel Uncertainty in Illness Scale for Adult (MUIS-A). A total of 166 questionnaires were distributed and 160 valid questionnaires were collected. Results? The total score of resilience of 160 young stroke patients was (58.70±5.54). The scores of tolerance, strength and optimism were (29.41±3.51), (20.24±2.37) and (9.04±1.46) respectively. Univariate analysis showed that there were differences in the resilience scores among young stroke patients with different genders, education levels, marital status and family relationships (P＜ 0.05). Relevant analysis showed that there was a positive correlation between resilience score and social support, and a negative correlation between resilience score and self-perceived burden and disease uncertainty (P＜0.05). Multivariate regression analysis showed that gender, educational level, family relationship, objective support, subjective support, emotional burden, economic burden and uncertainty and unpredictability were the main influencing factors of resilience. Conclusions? The level of resilience among young stroke patients is low and constrained by many factors. Nursing staff should take timely and targeted interventions to improve the level of resilience and promote the prognosis of the disease.

Objective To understand and analyze the effect and impact on Hospital-level Young Scholar Scientific Research Program in personal training and project promoting.Methods To review and analyze the archived documents and data materials of total 402 Young Scholar Scientific Research Program involving 339 young fellows from 2003 to 2013,compared the research input and output with general hospital level,including getting new fund,publications,Awards and patent.Results Output on researchers with Young Scholar Scientific Research Program is much higher than the general hospital level,but showing unbalanced distribution in medical disciplines.Conclusions To establishment of Young Scholar Scientific Research Program has achieved very good effect in promoting research in tertiary public hospital as well as has empowered the young fellows for conducting scientific research independently.It is proposed to go on strength the scientific management and optimize the system construction of research input,further establishing academic communication platform for young fellows.

Objective The study reviewed the exchanges and the outcome of the research cooperation of the platform of the Beijing International Cooperation Base for Science and Technology (ICBST),to explore a combined mode of internationalized research management of "base","talents" and "projects".Methods To analyze the outcomes of talents programs,international research cooperation projects and publications with the support of the Beijing ICBST.Results The establishment of BICBST has nurtured research talents to develop international vision,facilitated project-oriented international research cooperation,and encouraged high level research publication and grants.Conclusions ICBST is of great significance for the implementation of international research cooperation,which brought in more resources,cultivated a group of creative research talents,and broadened the channels for international collaborations and achieved capacity and influence of international competitiveness.

At present, there is no specific antidote for colchicine intoxication, and 0.8 mg/kg is its lethal dose.The prognosis of colchicine intoxication patients is closely related to the dosage, but the individual difference is very great. A 38-year-old man with colchicine poisoning was admitted to the Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, who had ingested 80 mg colchicine tablets (1.19 mg/kg) orally for 4 hours. He was immediately put on gastric lavage, enema, and catharsis. Continuous blood purification was performed for 34 hours and 22 minutes, with a combination of hemoperfusion (HP) and continuous veno-venous hemofiltration dialysis (CVVHDF). He also received a large dose of the glucocorticoid with 80 mg of methylprednisolone injected intravenously every 8 hours and organ function support. The patient was hospitalized for 2 weeks and discharged with improvement. The successful treatment of this case was reported for reference.

Objective:To study the environmental characteristics of launch section during the space medical rescue mission of Shenzhou-13 spacecraft, evaluate the influence of special environment on peripheral veins, and investigate the coping strategies.Methods:Combined with the practice of launch section during space medical rescue mission of Shenzhou-13 spacecraft, the main factors of aerospace special environment, cold and faint light, were selected and the related literature was reviewed to explore the feasibility, advantages and disadvantages of peripheral venipuncture, central venous catheter and bone marrow puncture. The experience of the space medical rescue mission was summarized and the coping strategies were provided for follow-up task training.Results:The environmental characteristics of launch section during the space medical rescue mission of Shenzhou-13 spacecraft included cold, faint light, sand-wind and complex terrain. The vascular filling, vascular elasticity and visibility of peripheral vein decreased in different degrees under special environmental, the vascular visibility was most affected. The literature analysis showed that bone marrow puncture was a suitable method to establish infusion access in cold and faint light environment.Conclusions:The special environment of space launch mission has greater impact on peripheral veins. In order to assurance the successful implementation of manned space project, the training of basic operational skills should be consolidated, the training of ability in special environment should be enhanced and the advanced clinical auxiliary equipment should be equipped in follow-up space medical mission training.

Objective By tracking survey of the mental disorder patients discharged from hospital , in order to propose continuum of care and social interventions strategy .Methods Using household survey method , totals of 525 elderly mental disorder patients from 2010 to 2012 were selected and surveyed using the Geriatric Depression Scale (GDS) and the Activities of Daily Living (ADL).Results Totals of 525 cases of senile mental disorders in community were surveyed with GDS .Totals of 86 patients scored 1 to 10 points, regarded as without depression, accounting for 40%.Totals of 79 patients scored 11 to 20 points, regarded as mild depression , accounting for 36.74%.Totals of 50 patients scored 21 to 30 points, regarded as severe depression , accounting for 23.25%.Totals of 422 patients (80.38%) had ADL score under 35 points, with different degree of lack of personal living capacity .Totals of 103 patients (19.62%) had ADL score between 40 to 100 points, with part or complete personal living capacity .Totals of 525 patients mainly depended on home care , within which 68.95%were taken care of by their family members and 11.43%were cared for by servants or hourly employee .Others (19.62%) were at nursing institution or hospitals taken care of by professional nurses .There was a big gap between the demand and supply of medical care service in community elderly long term care .Conclusions The problem of long-term care and social support of senile mental disorder patients is urgent , and based on the actual situation, we need to propose the corresponding social intervention strategies .